Great Eccleston Health Centre

Updated 6 March 2017

Great Eccleston Health Centre is registered with the Care Quality Commission to provide primary care services.

The practice provides services to approximately 7,500 patients from one location at Raikes Rd, Great Eccleston, Preston, PR3 0ZA. We visited this location on this inspection.

The practice is based in a purpose-built surgery building which is owned by the partners. It has level access and all patient services for the surgery are available on the ground floor.

The practice has 40 members of staff, including four GP partners (two female, two male), one salaried GP (male), one nurse practioner (female), four practice nurses (female), one pharmacy superintendent, one pharmacist, 12 dispensing staff (including two drivers), a practice manager, nine reception staff, and six administration staff, including a Medicines Manager.

The practice is part of Greater Preston clinical commissioning group (CCG). Information taken from Public Health England placed the area in which the practice was located in the second least deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice population profile consists of above average numbers of patients for all age brackets over 45. All age brackets under 45 have lower than average numbers of patients, with particularly lower-than-average numbers in the age groups between 20 and 39 years old.

The surgery is open from 8am to 6.30pm, Monday to Friday, with extended opening hours until 7pm on Mondays. The practice is also open from 8.30am to 12pm on Saturday. It is closed on Sunday. Telephones at the practice are answered from 8am until 6.30pm, Monday to Friday. Outside of these times a message on the telephone answering system redirects patients to out of hours or emergency services as appropriate. The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and GTD Healthcare.

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract agreement for general practice.

Updated 6 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Eccleston Health Centre on 11th January 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were generally assessed and well managed. On the day of inspection,we found some areas which needed addressing, and the practice did so immediately.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by the management team.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 March 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was better than the national average. The practice achieved 99.5% of the total QOF points available, compared to the national average of 89.8%. However, the exception reporting rate was higher than the national average (22.2% compared to 11.6%).
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 6 March 2017

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 88%, which was slightly higher than the local and national average of 82%.
• A child psychologist operated from the practice once a week.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered an in-house sexual health clinic for teenagers and young people.
• We saw positive examples of joint working with midwives, health visitors and school nurses. 

Updated 6 March 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in their population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Performance for conditions associated with older patients, such as heart failure, was better than the national average. The practice achieved 100% of the total Quality and Outcomes Framework points available for this condition, compared to the national average of 98.1%.

Updated 6 March 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 6 March 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Performance for mental health related indicators was better than the national average. The practice achieved 96.3% of the total QOF points available, compared to the national average of 92.8%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• 83% of patients diagnosed with dementia had had their care reviewed in a face-to-face meeting in the last 12 months. This was in line with the national average of 84%.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• A third-party counselling service offered one session a week from the practice. A child psychologist also operated from the practice once a week.

Updated 6 March 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.